Helpful approach for dementia and alzheimers patients.

[elleng]

My 95 year old Dad has just moved from Florida to Iowa to be near my brother and his family. His mind is sound but his hearing and vision are challenged, so he's in an assisted living facility. In reading about the place I came upon the following, which I think may be useful for many:

SunnyBrook Assisted Living Communities offer a dementia-specific Gardens Living Area. It is a smaller community of its own within the larger community structure. The Gardens’ goal is to provide individual care to those residents who can benefit from a smaller, more structured lifestyle that supports their current and future memory needs.

Many would say that dementia or Alzheimer’s robs the resident of who they are through the changes in their memory. At SunnyBrook Gardens we believe through purposeful days, guided living and individual interaction, each resident will still have a fulfilling life. We understand that with dementia/Alzheimer's care we at times have to have a “Who Does It Hurt” mentality.

SunnyBrook’s memory care philosophy is maintained with the idea that each staff member is joining the resident’s journey and supporting the resident’s current needs, thoughts, and beliefs. We agree with their current orientationto time and place and do not cause undo stress by attempting to reorient them to “our” current reality.

It is hard to see our loved one wearing unmatched, layered clothing, or not sleeping in their pajamas anymore. In the end “who does it hurt” regarding the choices a resident makes, and if it makes them happy or content, we can easily tell you “Who It Helps.”

Education, support, and training are provided to the loved ones of our Garden residents since we understand that it is a more difficult journey for the “one’s left behind” than for the resident who is on the memory changing journey themselves.

We encourage everyone to join in our journey of supported living with purpose, compassion, dignity, and respect.



http://www.sunnybrookseniorliving.com/gardens.html

[Warpy]

1. My own mother's dementia was the result of sensory deprivation

after she'd first gone blind and later deaf. I told my dad to let her wander around in the past because it was a hell of a lot better than her present. He reluctantly agreed with me and allowed her to go wherever she wanted to be at any time. We could still bring her into the present when we needed to, though.

I went to nursing school during that "reorient the patient frequently" BS they were teaching. The first Alzheimer's patient I had ever met years ago had told me this was a losing proposition on the line of teaching a pig to sing grand opera. Needless to say, I answered the test questions correctly and junked it in real life. Trying to keep my poor mother in the present instead of in pleasanter times would have been cruel beyond belief.

This is roughly the same set of guidelines I've used when coaching friends who have been caring for elderly parents at home. Don't sweat the small stuff, let them go where they want to mentally, and enjoy as much of them as you can for as long as you can.

[Digit]

2. I agree

As long as their own reality does not do them harm, or harm others, let them live in their own reality. Take care of their needs, protect them from harm, protect their dignity, provide for privacy, and you are at least on track.

I am a newbie at this as I will be doing clinicals as part of a nursing assistant class starting Monday. All I know is I will have a resident (long term care facility) that will need total care. I am quite nervous since I want to give the best care possible.

[elleng]

3. BEST OF LUCK,

and thank you.

Check back here if/when you'd like 'free' advice.

[Digit]

4. Thank you

I mentioned today in class something which disturbed me watching our videos....
The residents would look at their caregivers and the caregivers would not return the gaze. To me, it was almost like not acknowledging their humanity and it REALLY bothered me. To me, it is so basic, so very necessary to acknowledge them.
It was only a video of someone serving a meal to a resident, and the resident (who was a stroke victim), looked to the person serving her meal, but her gaze was not returned.

Possibly I am being ultra-sensitive.

[elleng]

5. No, Digit, you're not being ultra-sensitive.

You're being human.

A year ago my mother became ill, and I spent the next 9 months with her and my father; first home, then hospital, then nursing home, so I was able to observe lots. With it all, my mother had dementia - alzheimers. Awful to say this, but 'fortunately' for Dad, she passed on having not had alz symptoms very long.

SHE would have noticed a caregiver who didn't return her gaze; so would others I met there. In the longrun these momentary things are NOT very important, but they are noticed. AND family members notice, too, and WE think about this stuff all the time. 'What kind of care is she REALLY getting?'

THANK YOU again, forever.

[Digit]

6. My mother was treated inhumanely while in the ICU

She was restrained while suffering from pneumonia...tied down to the bed lying in a supine position.
One thing I have vowed is that I will not tolerate inhumane treatment in any way, shape or form.

Your loved one will get treatment as if they are a beloved family member.
I am a tad nervous because my standards are so high and I fully want to maintain those standards.
Luckily, my teacher is strict.

[Warpy]

8. If somebody's pulling tubes in the ICU, they get tied down

If somebody's pulling tubes on a med surg floor and there isn't a family member to sit with them 24/7, then they get tied down.

Your standards will change, trust me.

[Warpy]

7. There's a practical reason for that

which you'll find when you get out of school and get plunged into the real world of cost cutting in health care: the caregivers have to avoid being buttonholed by patients at all costs when they're doing time critical things like delivering hot meals. That usually means avoiding eye contact while they fly from meal cart to patient and back again.

Unfortunately that spills over into other care for some caregivers, especially as burnout from overwork sets in.

Sometimes the best you can do is acknowledge the patient by name, "Here's your lunch, Mrs._____, I've got to scoot."

I survived 25 years in the trenches and if I had it all to do over again, I would, so don't let this discourage you.